Should I Take Emergency Contraception After Starting Menstrual Regulation Meds?

If you have just started taking menstrual regulation medication and your ovulation period has already passed, you do not need to take emergency contraception?

Hello, Doctor.
Thank you for taking the time to read my message.
My last menstrual period was from February 15 to February 21 (it has been stable, with cycles approximately every 28 to 30 days).
However, around February 24, I experienced another menstrual period with heavy flow, which stopped by February 28.
Based on calendar calculations and observing my discharge, I noticed ovulatory discharge (clear and stretchy, like egg whites, with no odor) around March 3, along with an increase in basal body temperature, suggesting ovulation.
On March 12, I felt sharp pain in my right ovary and went to see a gynecologist.
An ultrasound revealed that my endometrium was very thick and that I had insufficient progesterone, leading to almost no normal ovulation and incomplete shedding of the endometrium during menstruation.
The doctor prescribed "Jing Tian Fu An Tablets" (white, pentagonal shape) for me to take two tablets a day.
Today (the 15th), I had intercourse with my boyfriend, and we used a condom throughout.
However, during the process, the condom broke.
My boyfriend immediately withdrew, but while cleaning up, we noticed a small amount of semen had been released, although it was definitely outside (after withdrawal).
I am concerned about whether there could be sperm left in the vagina due to pre-ejaculate fluid.
Since I am currently taking medication to regulate my cycle, I am unsure if I should take emergency contraception.

1.
What is your advice regarding the likelihood of pregnancy in my situation?
2.
Should I take emergency contraception?
3.
If I take it now, will it cause further disruption to my cycle?
Thank you for your response, and I appreciate your help!

Afu, 10~19 year old female. Ask Date: 2023/03/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
If you're still concerned, you can take emergency contraception.
Your period is also due soon, so it shouldn't have an impact.
Wishing you good health.

Reply Date: 2023/03/15

More Info

When considering whether to take emergency contraception after starting menstrual regulation medications, it's important to evaluate several factors regarding your menstrual cycle, the timing of ovulation, and the potential effects of the medications you are currently taking.

1. Understanding Your Cycle and Ovulation: Based on your description, it appears that you have a history of regular menstrual cycles, but you experienced an unusual occurrence with heavy bleeding shortly after your last period. This could indicate a hormonal imbalance, which your doctor has noted with the thickened endometrial lining and low progesterone levels. The presence of clear, stretchy cervical mucus around March 3 suggests that you were likely in your fertile window, which typically occurs a few days before ovulation.

2. Risk of Pregnancy: Given that you had unprotected intercourse on March 15, and considering that your ovulation was likely around March 3, the risk of pregnancy exists, especially since sperm can survive in the female reproductive tract for up to five days. However, since you mentioned that the intercourse was interrupted and that ejaculation occurred outside, the risk may be lower, but not negligible. Pre-ejaculate fluid can contain sperm, and if there was any leakage during the encounter, there is a possibility of sperm entering the vagina.

3. Emergency Contraception: Emergency contraception (EC) is most effective when taken as soon as possible after unprotected intercourse. If you are concerned about the possibility of pregnancy, taking EC can significantly reduce that risk, especially if taken within 72 hours of the incident. However, it can still be effective up to 5 days after unprotected intercourse, though the efficacy decreases over time.

4. Impact on Your Cycle: Regarding your concern about whether taking emergency contraception will further disrupt your menstrual cycle, it is possible. EC can cause temporary changes in your cycle, including altering the timing of your next period. However, it is generally safe to use EC even if you are on menstrual regulation medications. If you have already started taking the medication prescribed by your doctor, it is advisable to consult with them about the potential interactions and effects of taking EC alongside your current treatment.

5. Recommendations:
- Consult Your Doctor: Before making a decision, it’s best to discuss your situation with your healthcare provider. They can provide personalized advice based on your medical history and current medications.

- Consider Taking EC: If you are feeling anxious about the possibility of pregnancy, taking emergency contraception could provide peace of mind. It is a safe option and can help prevent an unintended pregnancy.

- Monitor Your Cycle: After taking EC, keep track of your menstrual cycle. If your period is delayed by more than a week, consider taking a pregnancy test.

In summary, while there is a risk of pregnancy due to the broken condom, taking emergency contraception can help mitigate that risk. It is advisable to consult with your healthcare provider to ensure that it is appropriate for your specific situation, especially considering the medications you are currently taking for menstrual regulation.

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